Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

MICHELLE PRUETT NP
NPI 1144092511
Nurse Practitioner - Pediatrics, Critical Care in San Diego, CA

Q: What is Michelle Pruett's NPI number?

The NPI number for Michelle Pruett is 1144092511. It was assigned to this individual provider in the NPPES registry on October 27, 2023.

Q: What is Michelle Pruett's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, Critical Care, with taxonomy code 363LP0222X.

Q: When was this NPI record last updated?

The NPPES record for Michelle Pruett was last updated on July 14, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 27, 2023PECOS Enrolled

3020 CHILDRENS WAY, SAN DIEGO, CA 92123(858) 976-5900 Get Directions Write a Review

NPPES record last updated: July 14, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 14, 2026, Oct 27, 2023 (2 updates tracked since 2023).

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About Michelle Pruett Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHELLE PRUETT NP (NPI 1144092511) is an individual pediatrics, critical care provider in San Diego, California, licensed in California (95027814) and active in the NPI registry since October 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Flagstaff.

NPPES Registry Identity

NPI1144092511

Entity TypeIndividualFemale

Primary Taxonomy363LP0222X

Provider Legal NameMICHELLE PRUETTCredential: NP

Location Address3020 CHILDRENS WAYSan Diego, CA 92123-4223

Mailing Address4852 Mount Alifan DrSan Diego, CA 92111-2510 · (330) 805-0630

Phone(858) 976-5900

Sole ProprietorNo

Enumeration DateOctober 27, 2023

Last NPPES UpdateJuly 14, 20262 updates tracked since enumeration

NPPES CertifiedJuly 14, 2026

✔ NPI 1144092511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Pediatrics, Critical CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0222X

Licenses✔ Licensed in CA · 95027814✔ Licensed in AZ · 330052

3020 CHILDRENS WAY, San Diego, CA 92123

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Secondary Practice Location 1

Location 11200 N Beaver StFlagstaff, AZ 86001-3118 · Phone (928) 773-2112 · Fax (928) 773-2237

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michelle Pruett Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92123 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$108.42 typical visit price

range $20.62 – $151.42

Typical copayment $27.10 (range $5.15 – $37.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.